Kimkins Myth #1: You can't starve if you have body fat
First, let me make this very clear: I am not a medical doctor. Nothing I write here should be construed in any way, shape or form as medical advice. However, I do have a doctorate in Biochemistry. That doesn't make me smarter than Kimmer and her minions it just ... nah. It makes me smarter than them :)
One oft-repeated claim by everyone's favorite discredited diet guru is that so long as you have an ounce of body fat on you, you will not starve. In fact, this individual claims there is no such thing as starvation mode, a statement she is uniquely unqualified to make. Nonetheless, on the face of it, this seems like it could make sense. If you don't eat, or severely restrict your calories, your body will naturally burn its own fat, and only its own fat, to make up the deficit, right?
Wrong.
Most people have an idea of what happens in hypothermia and frostbite -- the body shunts blood flow away from your extremities in an effort to preserve the brain and vital organs. You can live without fingers or toes, but you cannot live without a brain. Well, most people can't live without a brain. Your body will always, always prioritize functions in a way that ultimately preserves life.
If you enter a state of starvation or semi-starvation you will start burning body fat for fuel. But, and this is a big but, you will also begin to cannabilize your lean muscle mass at the same time. Yes, if you are obese you are going to 'burn' proportionally more fat for fuel than a lean person would, but you are most assuredly going to lose some muscle mass as well. Starvation isn't just about how many calories you consume, it also involves derangement of normal metabolism. If your body is consuming lean muscle as an energy source .... well, you're starving.
Why? Because muscle requires calories to maintain itself. One pound of muscle requires approximately 50 calories per day to maintain itself, as opposed to 2 calories a day to maintain a pound of fat. Your body has no idea whether or not you're eating 500 calories a day because you want your ex-husband's new wife to be jealous of your hawt new figure or because there was a massive natural disaster which wiped out most/all of the available food supplies, and it doesn't care -- the end result is the same. Your body will do whatever it can to preserve the only food supply it can count on -- its fat stores -- as best it can. Because muscle requires so many calories to maintain, it will reduce the amount of lean muscle mass as much as it can while preserving life in an effort to reduce the overall number of calories you need to stay alive.
May I just point out that consuming protein does nothing to prevent this.
An example -- suppose you are an individual weighing 200 lbs. You have undergone some fancy tests which reveal that 120 of those lbs represent lean body mass (which includes muscle/bone/organs) and the remaining 80 lbs is body fat. Now, suppose you know that of that 120 lbs of lean body mass, 60 lbs of that represents muscle. That 60 lbs of muscle will require approximately 3000 calories a day to maintain itself whereas the 80 lbs of fat will only require 160 calories to maintain itself.
Oh, Pshaw! Grilled Cheese Sandwich with Pickles Lady, you may be saying. Why should muscle require so many more calories to maintain itself? Because, dear reader, muscle is a lot more complicated than adipose tissue. A single muscle cell, called a myocyte, consists of many, many myofibrils which have a fairly complicated architecture and synthesis, which undergoes constant maintenance and repair in order to stay in working order. A single fat cell, called an adiptocyte consist of a basic cell with a glob of lipid in it. It requires almost nothing by way of maintenance. Furthermore, muscle is a better source of ATP (adenosine triphosphate, a molecule which all your cells use for energy, and which is synthesized from carbs, fats and proteins) than fat.
Now, suppose you're absolutely desperate and pay a morbidly obese woman a cool $60 to join her diet site, even though there is no indication anywhere that she ever successfully applied it it herself. This diet bills itself as a tweaked version of Atkins and Stillman's, basically keeping carbs at 20 g or less per day, 70-90 g of lean protein, and 'just enough fat to make it work." This diet, at best, permits 760 calories a day based on 20 g of carbs and 90 g protein. Suppose you decide 'just enough fat to make it work' means around 20g on a bad day (that's just under an ounce, BTW) -- well, you've just added 180 calories to your total which means that at the higher end of Kimkins you are consuming just 940 calories per day.
That, dear reader, is 460 calories less than the best meal you'd be served at Auschwitz and frankly, that way lies madness.
Elle
22 Kerfuffles:
Great Post!!!
Thanks so much for putting the true science out there.
You ARE smarter than them....lol
This is a great "article" winkwink nudgenudge.
y.y.
Great explanation! Too bad more people haven't studied human physiology...I guess it's just easier to take the word of a big fat liar who lies (*cough* Heidi Diaz *cough*).
Brilliant post! I added a link to it on my blog, Medusa
(http://2medusa.blogspot.com/)
Excellent! Absolutely excellent post!
First let me say I don't support kimkins or kimmer.
I just want to clarify a myth (debunking myths of debunked myths heh?)
IT has been demonstrated that muscle is actually not more metabolically activet han fat tissue. Muscle at work burns a lot of calories; muscle at rest is about the same as fat. Most of the time, our muscles are at rest.
Also, it is true the more body fat a person has, the more resistant against starvation they are. The state of starvation - which is simplified down to metabolic slow down so as to prevent tissue mass loss during food deprivation - it is controlled almost entirely by messages sent from body fat.
There is a much smaller part of diet (insulin) but mostly it's body fat (even if insulin is high, leptin will not be sufficient unless body fat stores are sufficient).
It is possible to starve to death while overweight/obese... it's just much, much more difficult to do than when thin, that's all. The preexisting health conditions of very obese people are more likely to be an issue than any that come from food restriction itself.
itsthewoo,
I'm going to respectfully disagree :)
Muscle tissue undergoes constant repair as just the simple act of using it breaks it down. You are going to break more of it down on an elliptical trainer than you will walking to the kitchen for a bag of chips, but if you use it, you are shredding some of those myofibrils etc. which must be replaced.
I'd also disagree with your statement that "Most of the time, our muscles are at rest." Most of the time our muscles are not being worked hard, but every time you move, a muscle is at work and a rather large chunk of your total muscle mass involves muscle mass involved in involuntary functions -- that is, smooth muscle in your heart, vascular tissue, your digestive system, your diaphragm (okay, that's semi-involuntary) and others.
All of that muscle is constantly at work and must be constantly maintained, which is why its energy requirements are so high. Granted, my glutes are at rest right now, but my digestive system is hard at work. My adiopocytes are just sitting there.
That said, I never mind being challenged and proven wrong. Can you point me to those studies? Also, if you say it's okay, I'd like to promote your comment(s) and my response to the main body of the page so others can follow.
Thanks for your comment --
LC
Gah, posted too early. Regarding your comment about the obese being more resistant to starvation -- sure, in the sense that they have more body fat. But starvation is not simply a question of how many calories you ingest, it's more to do with the metabolic derangement that occurs when key nutrients are missing. Kwashiokor (sp?) is an example of this, it's a form of starvation that occurs when protein is deficient in the diet, common in third-world countries. The diet may be adequate or nearly adequate in terms of caloric intake, but because there is a dearth of protein, the afflicted individual is starving nonetheless.
LC
thanks for all the great informational posts you are making debunking the kimkins.con myths
2BIG
Hi - Here is a discussion about the resting energy expenditure of various body tissues: http://www.obesityresearch.org/cgi/content/full/9/5/331
According to this, the muscle and fat both burn a paltry amount of calories. More effective means of losing weight would be to increase your heart rate; I suppose that's why sympathomimetic drugs and stimulants are the crash dieter's friend.
Yes, it is true muscle undergoes constant repair. This is what costs the 6 cals/pound. Fat tissue also undergoes constant influx and outflux of fatty acids. This contributes to the 2 cals/pound maintenance cost (the value of the fat itself, and the energy to store it, is about 2 cals/pound to maintain that level of fat).
Building muscle tends to go along with other conditions that burn a lot of energy - an increased heart rate (increased sympathetic stimulation), increased sex steroid levels (testosterone), all of these will increase your metabolism. But, thing is, fat tissue does as well, so this is not unique to building muscle.
Here is an excellent discussion written by an exercise physiologist about the whole fat vs muscle debate.
http://exercise.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=exercise&cdn=health&tm=1386&gps=269_1198_1325_730&f=00&su=p726.2.152.ip_p674.2.400.ip_p284.8.150.ip_&tt=12&bt=0&bts=0&zu=http%3A//www.thefactsaboutfitness.com/news/cals.htm
Basic take home message is that muscle burns a whole lot less than we think (duh) whereas fat increases the metabolism in indirect ways. Even if muscle burns 3xs as much energy as fat (which btw still isn't much at all - the difference between 6 calories per pound vs 2 per pound).... fat tissue secretes numerous hormones that increase metabolism. A starved person (that is an underweight person) makes very little leptin, estrogen, testosterone, less adrenal/sympathetic system stimulation etc. Body fat is actually a very metabolically costly tissue, perhaps not directly, but via its effects on the endocrine system.
A very obese person has a very high metabolic rate, independent of food intake, as a result of their increased fat mass (2 cals/pound) as well as heightened levels of pro-metabolic hormones (these hormones not only promote energy syntehsis but also muscle development).
In contrast an underweight person has not only reduced fat mass and muscle mass but their whole body is in a sort of conservation state; this conservation state exists totally independent of nutrition. Every endocrinological axis in their body is suppressed to conserve energy as a direct effect of diminished fat tissue.
Regarding your comment about the obese being more resistant to starvation -- sure, in the sense that they have more body fat. But starvation is not simply a question of how many calories you ingest, it's more to do with the metabolic derangement that occurs when key nutrients are missing.
Body fat is an endocrine organ. To avoid a death-like suppression of all metabolic activities, one must have adequate or greater fat mass. And yes, the fatter we are, the more our metabolism will be increased. The increase in how all of our body systems function - heart, brain, kidneys, thyroid adrenals, and yes muscles too --- it's controlled by fat.
It is possible to starve to death while obese. It just requires one of the following conditions:
1) Extreme nutrient/protein deficiency (which, unless we are talking next to no protein or total starvation, shouldn't be a problem for any reasonably healthy obese person for at least a couple of months/weeks... because the obese person's fat cells will continue to secrete leptin, and this will prevent metabolic collapse. The leptin will support adrenals, thyroid, thus all secondary organs and tissues. Energy for this support will come from the fat itself.
2) A preexisting metabolic abnormality (e.g. hypothyroidism)... but in this case it is more the metabolic abnormality causing the obesity and the premature starvation state. Without a functioning thyroid, for example, all the leptin in the world isn't going to prevent cardiomegaly and eventual death. Food restriction would just exacerabate the strain on the metabolic disease, but it wouldn't cause it. A normal obese person will not starve to death on a very low calorie diet with minimum nutrition (and by this I mean protein, and vitamin/mineral supplements, which any responsible dieter should be taking).
If a very obese person goes on a 1000 calorie diet, their overful fat cells will continue to promote normal metabolism (or at least, not conserve energy as greatly) as compared to a normal or underweight individual who goes on that same 1000 calorie diet.
In the normal/underweight individual, they depend much more on food intake to support their metabolism.
A personal anecdote: When I was underweight (strike one) and restricting food (strike two) I actually started to feel WORSE on very low carb. The hit of insulin from a bit more carbs, while not sufficient to promote fat gain, it was enough to stimulate my fat cells to make more of these pro-metabolic chemicals (leptin mainly) to prevent me from feeling quite as much like sh*t. I actually felt less hungry, and less fatigued, because slightly higher carb intakes helped my fat cells to work.
Additionally, when I was underweight, I only ever felt reasonably alive after a meal. I could not go any length of time without food, because I would have zero energy. It was really similar to being half alive. This does not happen to obese people, or even normal weight people. Obese people seem to be able to go for great lengths of time without food (provided they don't have hyperinsulinemia and hypoglycemia). Even normal weight people find it relatively easy to delay a meal (although, from observation, with a lot more hunger than an obese person).
Those with the least fat, conserve the most energy when food is restricted. No other outcome can be expected when we appreciate the fact that fat is an endocrine organ.
That conservation state is what truly makes up starvation. It's more than feeling tired and sh*tty, it's also robbing our bones, and our heart, of the materials necessary to promote health, via thyroid suppression. Starvation is nothing more than functional hypothyroidism. The same things that kill / hurt hypothyroid patients (heart death and if long term then osteoporosis mainly) also kills/harms starving people. The thyroid is what does it. And without enough leptin (and fat people have leptin) your thyroid doesn't work.
I'm not arguing that nutritional deficiencies can cause specific types of starvation, I am aware of many kinds of nutrient deficiencies. Thing is, it is easy to prevent these deficiencies, in a low energy diet.
And while kimmer/kimkins definitely was an irresponsible diet, an unhealthy/unsafe crash diet... a low energy diet in the obese individual is in no way shape or form going to prmote starvation or metabolic conservation assuming there is no preexisting undiagnosed/untreated metabolic disease (e.g. leptin deficiency, or hypothyroidsim, in which case restriction would only exacerbate, not CAUSE, the complications , the same way high protein intake exacerbates renal failure but in no way contributes to it).
You may link to my responses if you wish :)
Thanks
Nora
One thing, you mention pre-existing thyroid conditions but what about the changes to thyroid hormones as a result of very low calorie dieting?
Wooo, you said, "Extreme nutrient/protein deficiency (which, unless we are talking next to no protein or total starvation, shouldn't be a problem for any reasonably healthy obese person for at least a couple of months/weeks... because the obese person's fat cells will continue to secrete leptin, and this will prevent metabolic collapse. The leptin will support adrenals, thyroid, thus all secondary organs and tissues. Energy for this support will come from the fat itself."
This sounds like a scientific version of what Kimmer said.
In a normal, healthy obese individual on a very low calorie diet, does the presence of leptin prevent:
Decreased thermogenesis?
Muscle wasting?
Lethargy?
Myocardial atrophy?
All of these are documented responses to very low calorie diets, even in persons who consume supplements and get most of their calories from high quality protein. An obese person may be able to withstand these symptoms longer than a lean person can, but obese people are, unfortunately, leptin-resistant. Just like a lean person on a very low calorie diet, their bodies will do everything possible to conserve energy, and if they do not eat sufficient calories they will eventually succumb to starvation.
Sherrie - in low calorie dieting, the active thyroid hormone, T3, decreases. This is a functional form of hypothyroidism. Pretend your body is a house with a thermostat. When it's cold outside, we turn the thermostat up... when it's warm, we turn it down. The body does this with our thyroid. When we have access to a lot of food and a lot of body fat, the body turns up the thermostat and thyroid increases. When we have access to less food and less body fat, the body decreases thyroid hormones. This isn't a disease, it's normal physiology, and it is completely reversable with weight change and nutrition.
Severe nutrient deficiencies can contribute to pathological hypothyroidism (protein and iodine malnutrition), and starvation in general confounds the immune system which can promote autoimmune thyroid disease. But low calorie dieting isn't going to cause thyroid disease.
Thyroid disease tends to cause weight problems and depression, and those with weight problems and depression tend to try to lose weight to feel better. Correlation, not causation.
This sounds like a scientific version of what Kimmer said.
Well, the thing is, kimkins - the front of hte plan - it wasn't such a bad diet. The problem with kimkins has always been the plan behind the plan. Trying not to eat, fasting if possible, laxatives, and a general irresponsible nutritional approach.
We should distinguish between the parts of kimkins that were not-harmful, and the parts that were. Low calorie dieting with adequate nutrition, in the short term, for a very obese person, is not harmful. If minimum nutrients are met, and meals are consumed regularly to promote proper absorption, and they are monitoring hteir health and seeing doctor as needed... it is not dangerous.
In a normal, healthy obese individual on a very low calorie diet, does the presence of leptin prevent:
Decreased thermogenesis?
Muscle wasting?
Lethargy?
Myocardial atrophy?
Yes, it does. First let me say a decrease in thermogenesis is benign because thermogenesis directly translates to caloric intake (just like thyroid function; hyperthyroid in food / fat excess and hypothyroid in food / fat deficit, thermogenesis follows energy availability). Lethargy, too, correlates with body fat and food; obviously you aren't going to feel as energetic while losing weight as you might while maintaining weight. But, this lethargy shouldn't be of the crippling-starvation kind.
Whenever we lose weight, we lose some muscle mass, simply because fat and muscle go hand in hand. Insulin promotes storage of fat and it also promotes insulin growthh factors which make our muscles bigger. If we reduce insulin, we reduce fat, and perhaps muscle as well (although not as much as fat).
Now with that said...
Leptin will directly prevent myocardial atrophy, severe muscle wasting, and severe lethargy, by supporting the thyroid. Thyroid function does decrease during low cal dieting, but it is temporary and very, very limited if the individual has high body fat with high leptin. Assuming protein is adequate, AND body fat / leptin is adequate, these complications are avoided.
The problem with a lot of these low cal diets is "adequate body fat" and "adequate protein" are incorrectly defined. SOmeone with moderate overweight isn't going to tolerate a very low energy+low carb diet well (even if she perceives "adequate body fat"). Soemone who eats 500 cals per day with like 60-80 grams of protein is simply in starvation. The more cals decrease, the more protein needs to increase. And there are calorie intakes so insufficient that there is no way around metabolic suppression. There is no reason I can think of to eat less than 1000 calories, at any weight. Fat loss is not going to increase, but you will perhaps lose more lean mass and feel a lot worse from metabolic suppression (decrease in hormones that make energy and support health).
If one is truly severely obese, and if their diet is low - but adequate, there should be weight loss with none of those severe complications of starvation.
All of these are documented responses to very low calorie diets, even in persons who consume supplements and get most of their calories from high quality protein. An obese person may be able to withstand these symptoms longer than a lean person can, but obese people are, unfortunately, leptin-resistant. Just like a lean person on a very low calorie diet, their bodies will do everything possible to conserve energy, and if they do not eat sufficient calories they will eventually succumb to starvation.
Leptin resistance in obesity is related to hyperinsulinemia. If we can get insulin levels down, sensitivity to leptin is restored. There are exceptions of genetic leptin defects but they are exeptions.
And yes, leptin sensitivity is likely not totally restored, which is why obese people tend never to become truly slim. But, the point is, all weight loss occurs by reducing insulin so that the body can hear leptin knocking. ... and weight gain occurs when insulin increases which prevents leptin perception. Insulin resistance, high insulin, and high leptin cluster together.
Obese people are susceptable, as they become less obese and their leptin decreases, they will tolerate the diet less and less. They make less leptin the more fat they lose, and the less they eat. That's why was we become thinner it is important to eat more, not less, calories. This is the rationale behind ongoing weightloss, the carb ladder, and transitioning into maintenance. As we deplete our body fat, we lose our ability to tolerate low intakes, and we must steadily increase our diets to maintain health and well being.
And, please, it do seperate in our minds the difference between a reduced calorie diet That is adequate and one that is deficient. Any person will have problems on a deficient diet no matter their weight. 500 cals is deficient. I don't care if it is all of protein, it's deficient. Your metabolism will not work with that little of an intake. But if we increase the energy by 100% or more (1000 cals), and provide adequate fats and protein... this diet can be used for weight loss with minimal if any side effects provided sufficient obesity and health.
I also want to say I don't promote very low calorie diets (I consider 1000 cals a very low calorie diet; for the majority of prospective dieters this is not an energy reduction enough to be starvation-level, because it should avoid the severe complications associated with starvation ).
I believe obesity is a disease, and it can be defeated by controlling insulin levels while honoring your body. Eating high fat, low carb, and making an effort to eat when hungry (and NOT eat when NOT hungry) is all that is needed.
By way of reminder, the title of this topic is, "Kimkins Myth #1: You can't starve if you have body fat."
And from what you and I have discussed here, it is obvious that you *can* starve if you have body fat. The rest of the discussion about calories, thyroid function and leptin is interesting, but unfortunately it distracts the readers here from that simple truth.
You CAN starve if you have body fat. And if you're not paying attention, it is not particularly hard to do it.
To Bamagal - I'm not a "research biologist" but does this make what I say invalid? Again you prove your inability to form logical conclusions. I've yet to see you say one single logical insightful thing, in fact. It must be frustrating having no ability to solve problems and shite for insight. Combined with a penchant for stirring crap with people and being very personally antagonistic, you must have a frustrating life indeed. Maybe your violence and passive-aggrisive hostility is a product of your deaf dumb and blind brain? Either way.
Frownies for you :( .
Have fun spending 24/7 talking sh*t about people, all the same, you fount of empathy, you.
To Magicsmom - Takes one to know one, duck freakshow!
To CJane - I've been opinionated long before nursing school, and trust me almost none of my opinions about health and wellness come from nursing school. This started when I was about 3 years old. Ha ha. I consider it a strength, not a weakness. I'm the only student who stands up to doctors. I argue instructors. I ask questions and I want to know why (and if I think I know why I want others to know why too). It's been more of an asset than a hindrence.
[ Anonymous said...
Wooo, you said, "Extreme nutrient/protein deficiency (which, unless we are talking next to no protein or total starvation, shouldn't be a problem for any reasonably healthy obese person for at least a couple of months/weeks... because the obese person's fat cells will continue to secrete leptin, and this will prevent metabolic collapse. The leptin will support adrenals, thyroid, thus all secondary organs and tissues. Energy for this support will come from the fat itself."
This sounds like a scientific version of what Kimmer said.]
Actually no, Kimmer never said that, what she said was that you could do this for as long as you had fat on your body and often mentioned a study regarding water fasting for 382 days!
Also she never just said this too obese people either...
Yes I am aware of that but at least with some studies I was reading that were freely available online, they do seem to suggest reductions in T3 that are not accounted for by weight loss alone that don't completely return to normal upon refeeding. There was also one that suggested carbohydrate intake having an impact as well.
Then there are risks from rapid weight loss like liver changes and gall stones.
Plus there is the psychological side of this kind of dieting as well.
One thing with kimkins her diets didn't have minimums nor a time limit of 2 months/weeks, as far as she was concerned you could do it for as long as you want.
Personally I don't think those type of diets should be done so light heartedly and hers not at all.
Thank you for debunking this Kimkins Myth.
I can't believe that anyone, not even Heidi, would be idiotic enough to try to pass this one along as truth.
woot woot
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